What is a medication to suppress coughing: A guide to antitussives

October 8, 2025 •

5 min read

According to the American Academy of Family Physicians, over-the-counter (OTC) cough medicines have not been proven particularly effective in children under 6 years old, highlighting the importance of understanding the right treatment options. For adults seeking relief, the answer to "What is a medication to suppress coughing?" depends on the type and cause of the cough.

Quick Summary

Different medications are available to suppress coughing, including over-the-counter (OTC) antitussives like dextromethorphan and prescription options such as benzonatate and codeine. These medications work by acting on the cough reflex, either centrally in the brain or peripherally in the respiratory tract. The best choice depends on whether the cough is dry or wet, its underlying cause, and other individual health factors.

Key Points

Dextromethorphan (DXM) is the most common OTC option: A centrally acting antitussive found in many cough syrups and capsules, best for temporary relief of dry coughs.
Prescription opioids like codeine are for severe cases: Medications such as codeine and hydrocodone are effective but carry risks of dependence and are generally reserved for more distressing coughs.
Benzonatate acts locally on lung receptors: This prescription drug anesthetizes lung stretch receptors to suppress the cough reflex and must be swallowed whole to avoid serious side effects.
Home remedies offer a non-drug alternative: Simple measures like honey, warm fluids, saltwater gargles, and humidifiers can effectively soothe and calm a cough, particularly for milder cases.
Match the medication to the cough type: Antitussives are best for dry coughs; they should generally be avoided for productive coughs to prevent mucus buildup in the lungs.
Consult a doctor for persistent or severe symptoms: Seek medical advice for a cough lasting several weeks or accompanied by serious symptoms like fever, wheezing, or bloody phlegm.

Understanding cough suppressants

Coughing is a natural reflex to clear the airways of irritants, mucus, and foreign particles. While beneficial, a persistent, dry cough, also known as a nonproductive cough, can be irritating and disrupt sleep. Medications designed to suppress coughing are called antitussives, and they work by blocking the cough reflex. The most appropriate medication depends on the nature of the cough, with different agents targeting different mechanisms. It is important to note that cough suppressants are generally not recommended for a productive cough, which helps clear mucus from the lungs, as this could lead to a worsening of symptoms in conditions like COPD or pneumonia.

Over-the-counter (OTC) cough suppressants

Over-the-counter medications are the most common first line of defense for a minor, temporary cough. The primary active ingredients are dextromethorphan and diphenhydramine.

Dextromethorphan (DXM)

Dextromethorphan is the most widely available OTC cough suppressant. It is found in many brand-name and generic products and is suitable for treating a dry cough.

How it works: DXM is a centrally acting antitussive that works by decreasing activity in the part of the brain that triggers the cough reflex.
Forms: It comes in various forms, including syrups (e.g., Delsym), gel caps, and lozenges.
Considerations: At recommended doses, it is safe and effective for temporary relief. However, it can cause mild side effects like dizziness, drowsiness, and stomach pain. High doses can lead to serious adverse effects and abuse potential.

Diphenhydramine

This is an antihistamine primarily used for allergy symptoms, but it is also recognized for its antitussive effects. Its sedating properties make it a common ingredient in nighttime cold and cough formulas.

How it works: Like DXM, diphenhydramine acts on the cough center in the brain to suppress the cough reflex. Its antihistamine action can also help reduce coughing caused by postnasal drip.
Considerations: Its sedative effect can be a benefit for sleep but may cause daytime drowsiness. Older adults should consult a healthcare provider before use due to concerns about dizziness and cognitive impairment.

Prescription cough medications

For more severe or persistent coughs, a healthcare provider may prescribe a stronger medication. These are often controlled substances due to their potential for abuse and side effects.

Codeine and Hydrocodone

Opioid agonists like codeine and hydrocodone are effective cough suppressants but are generally reserved for more severe cases due to the risk of dependence and respiratory depression.

How they work: These narcotics act directly on the brain's cough center.
Forms: Available by prescription, often in combination with other ingredients like guaifenesin or antihistamines.
Considerations: In 2018, the FDA revised labeling to restrict use to individuals 18 years and older due to serious risks, particularly for children. Side effects can include sedation, constipation, and breathing issues at high doses.

Benzonatate

Benzonatate is a prescription-only, non-narcotic cough suppressant.

How it works: Its primary mechanism is a local anesthetic effect on the stretch receptors in the lungs and airways, effectively dampening the cough reflex peripherally. It may also have a central antitussive effect.
Forms: It is available in liquid-filled capsules that must be swallowed whole to prevent oral numbness.
Considerations: Chewing or sucking the capsules can cause serious side effects like laryngospasm or circulatory collapse. It is approved for use in patients aged 10 and above.

Home and natural remedies

Before reaching for medication, many people find relief from simple, natural methods. These can be effective for soothing an irritated throat and calming mild coughs.

Honey: A teaspoon of honey can help relieve a cough by coating the throat. Studies suggest it can be as effective as dextromethorphan for this purpose. Note: Do not give honey to children under 1 year old due to the risk of botulism.
Warm liquids: Drinking warm tea, broth, or other liquids helps thin mucus and soothe a sore throat. Herbal teas with ginger or peppermint may provide extra relief.
Saltwater gargle: Gargling with warm salt water can soothe an irritated throat, particularly if the cough is caused by postnasal drip.
Humidifiers: Using a cool-mist humidifier or breathing in steam from a hot shower can moisten the airways, preventing the dryness that triggers the cough reflex.

Comparison of cough suppressants


Feature	Dextromethorphan (OTC)	Codeine/Hydrocodone (Rx)	Benzonatate (Rx)
Mechanism	Central action on the brain's cough center.	Central action on the brain's cough center.	Peripheral action on lung stretch receptors; some central effect.
Cough Type	Dry cough.	Severe dry cough.	Non-productive (dry) cough.
Safety & Risk	Generally safe at recommended doses; potential for abuse at high doses.	High risk of dependence and abuse; potential for respiratory depression.	Serious risk if chewed/sucked; inadequate evidence for efficacy/safety in recent reviews.
Availability	Over-the-counter.	Prescription only (in most states).	Prescription only.
Primary Use	Temporary relief of minor cough.	Severe, distressing cough; typically short-term.	Symptomatic relief of persistent, non-productive cough.

When to see a doctor

While OTC medications and home remedies are often effective for mild, temporary coughs, you should consult a doctor if the cough persists or is accompanied by other symptoms. Seek medical advice for a cough lasting longer than a few weeks or if you experience any of the following:

Wheezing or shortness of breath
High or persistent fever
Thick, yellow, or green phlegm
Coughing up blood or pink-tinged mucus
Chest pain
Trouble swallowing or breathing
Significant weight loss

Conclusion

Finding the right medication to suppress coughing is crucial for effective relief. For most minor, dry coughs associated with the common cold, OTC options like dextromethorphan offer a safe and convenient solution. For more persistent or severe cases, or for individuals with underlying respiratory conditions, prescription alternatives such as benzonatate, codeine, or hydrocodone may be necessary and should be used under medical supervision due to potential risks. Furthermore, simple home remedies like honey and warm fluids can provide soothing relief. Always consider the type of cough, potential side effects, and any underlying health issues when choosing a treatment. If your cough is severe or persistent, a consultation with a healthcare professional is the best course of action. For additional details on specific medications, refer to authoritative sources like the MedlinePlus Drug Information page on Dextromethorphan. [https://medlineplus.gov/druginfo/meds/a682492.html]

Note: This article is for informational purposes only and is not a substitute for professional medical advice. Always consult a healthcare provider before taking any medication.

Frequently Asked Questions

The most common over-the-counter cough suppressant is dextromethorphan (DXM). It is the active ingredient in many non-prescription cough syrups, capsules, and lozenges, and it is most effective for relieving dry coughs.

Dextromethorphan works by acting on the cough center in the brain, decreasing its activity and raising the threshold for triggering the cough reflex.

Common side effects of OTC cough suppressants like dextromethorphan and diphenhydramine can include dizziness, drowsiness, and stomach discomfort. At very high doses, dextromethorphan can cause more serious effects such as hallucinations or seizures.

A healthcare provider may prescribe a stronger cough medication for a severe, persistent cough that does not respond to OTC treatments. This is especially true for specific medical conditions where an opioid-based or other prescription antitussive is deemed necessary and appropriate.

The FDA has restricted the use of codeine and hydrocodone in people under 18 due to concerns over the risk of respiratory depression (breathing problems) and potential for addiction. These are opioid medications that carry more significant risks than non-opioid antitussives.

A cough suppressant, or antitussive, works to stop the cough reflex, making it suitable for a dry cough. An expectorant, like guaifenesin, works by thinning and loosening mucus, which helps a person with a productive (wet) cough clear their airways.

You should see a doctor if your cough lasts more than a few weeks or is accompanied by wheezing, fever, green or yellow phlegm, shortness of breath, chest pain, or coughing up blood.

Yes, effective home remedies include drinking warm liquids like tea or broth, gargling with salt water, using a cool-mist humidifier, and consuming a small amount of honey (for adults and children over 1 year old).